10D1017632 CLIA NUMBER - BAPTIST PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D1017632
  • Facility Name: BAPTIST PRIMARY CARE
  • Facility Address: 1370 13TH AVE SOUTH MOB A STE 216
    JACKSONVILLE BEACH, FL
    ZIP 32250
  • Facility Phone: 904 247-7778
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE R. TAMAYO
  • NPI Number: 1689189540
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1017632
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE
Street 1370 13TH AVE SOUTH MOB A STE 216
City JACKSONVILLE BEACH
State FL
ZIP 32250
Phone 904 247-7778
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2025
Certificate Expiration Date 9/29/2027
Facility Type Physician Office
Lab Director JOSE R. TAMAYO

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This page was last updated on: 9/29/2025